Factors Affecting the Fracture Resistance of Post-Core Reconstructed Teeth: A Review

Purpose: This article presents a review of the literature on factors that affect the resistance to fracture of post-core reconstructed teeth. Materials and Methods: Articles cited in a MEDLINE search were obtained from the journals and reviewed with respect to factors affecting fracture resistance of post-core reconstructed teeth. Results: A large part of the literature reviewed emphasizes the stress distribution during insertion of posts and during function. Other factors, like post length, post diameter, amount of remaining dentin, post material, post adaptability, post design, cement, core material, core and crown design, biocompatibility of post material, use of treated tooth, and load experienced by restored tooth, are also found to influence the fracture resistance of a reconstructed tooth. Of all the factors enumerated, crown design, occlusal forces, and use of the treated tooth are found to have direct impact on the longevity of the restored tooth. Conclusion: Literature indicates that (1) preservation of tooth structure is a must; (2) posts should not be used with the intention of reinforcing the tooth; (3) review of functional and parafunctional forces must be undertaken before restoring the tooth, as these will influence the prognosis; and (4) controlled prospective clinical studies evaluating each factor should be undertaken.